自体真皮移植联合负压封闭引流技术修复肌腱骨质外露伴腔隙创面的疗效观察  

Observation on the Curative Effect of Autologous Dermis Grafting Combined with Vacuum Sealing Drainage in Repairing Tendon Bone Exposure with Lacunar Wounds

作　　者：许建允 张新合 孟红阳 雷磊[1] 李金虎 许晓鹭 陈志军[1] 肖益伟 杨新蕾[1] XU Jianyun;ZHANG Xinhe;MENG Hongyang;LEI Lei;LI Jinhu;XU Xiaolu;CHEN Zhijun;XIAO Yiwei;YANG Xinlei(Department of Burn and Plastic Surgery,the 73rd Army Group Hospital of the PLA,Xiamen 361000,Fujian,China)

机构地区：[1]中国人民解放军陆军第73集团军医院烧伤整形外科,福建厦门361000

出　　处：《中国美容医学》2023年第12期29-32,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:观察自体真皮移植联合负压封闭引流技术修复肌腱骨质外露伴腔隙创面的疗效。方法:选择2020年1月-2022年7月于笔者医院就诊的创面骨质肌腱外露伴腔隙的60例患者为研究对象进行前瞻性研究,入选患者按随机数字法分为观察组和对照组,各30例。所有患者均给予自体真皮移植治疗,术后观察组给予负压引流治疗,对照组给予常规引流治疗。比较两组患者围手术期指标、术后瘢痕情况[温哥华瘢痕量表(Vancouver scar scale,VSS)]、创面美学效果及患者满意度。结果:术后,观察组皮片成活率高于对照组(P<0.05),住院时间短于对照组(P<0.05);术后3个月,观察组VSS评分低于对照组,创面总体美观性、创面与健侧的对称性、皮肤颜色的美观性评分均高于对照组,患者满意度高于对照组,差异均有统计学意义(P<0.05)。结论:自体真皮移植联合负压封闭引流技术修复肌腱骨质外露伴腔隙创面,可提高皮片成活率,减少瘢痕形成,美学效果好,患者满意度高。Objective To observe the efficacy of autologous dermis grafting combined with vacuum sealing drainage in repairing tendon bone exposure with lacunar wounds.Methods From January 2020 to July 2022,60 patients with bone and tendon exposure of wounds with Lacunar in the author's hospital were selected as the research objects for prospective study.The selected patients were divided into observation group and control group according to the random number method,with 30 cases in each group.All patients were treated with autologous dermis transplantation.After operation,the observation group was treated with vacuum sealing drainage,and the control group was treated with conventional drainage.The perioperative indicators,postoperative scar condition[vancouver scar scale(VSS)],wound aesthetic effect,and patient satisfaction were compared between the two groups.Results After operation,the survival rate of skin graft in the observation group was higher than that in the control group(P<0.05),and the hospitalization time was shorter than that in the control group(P<0.05).At 3 months after operation,the VSS score of the observation group was lower than that of the control group,the overall wound aesthetics,the symmetry of the wound and the healthy side,and the aesthetic score of skin color were higher than those of the control group,and the patient satisfaction was higher than that of the control group,and the differences were statistically significant(P<0.05).Conclusion Autologous dermis grafting combined with vacuum sealing drainage for repairing tendon and bone exposure with lacunar wounds can improve the survival rate of skin grafts,reduce scar formation,have good aesthetic effect,and have high patient satisfaction.

关 键 词：自体真皮移植 负压引流 肌腱外露 骨质外露 腔隙性创面 修复 美观性 

分 类 号：R622[医药卫生—整形外科]